Q :   My spasticity comes and goes and is often triggered by heat – I’ve tried ice but is there anything else I can do to help prevent it coming on?
A :   The first thing to do in order to prevent heat from worsening an MS symptom is to avoid it whenever possible. Moderately warm showers rather than hot ones are recommended. Many people with MS also avoid sunbathing and performing some activities in the heat (such as exercising under the hot midday sun). Other ways to help curb the heat’s influence on worsening symptoms is to use air conditioning, drink cold beverages and wear light, loose-fitting clothing. Some people with MS use a body cooling system to avoid becoming overheated. While these systems are available in different countries, they can be very expensive and have not been tested in rigorous studies with large numbers of subjects.

Q :   My legs are often sore and stiff at night and stop me from sleeping. Why are the symptoms worse at night and are there any exercises I can do before bed to help?
A :   You may be describing restless leg syndrome (RLS), a condition in which your legs feel extremely uncomfortable while at rest. RLS has been found to be a very common problem for people with MS, although the cause is unclear.

An evaluation at a centre that specialises in sleep disorders would help to better understand your symptoms. The feeling is usually relieved by moving around and this is why it seems like the symptoms worsen at night. Some strategies for managing RLS include reducing caffeine and alcohol intake and regular, moderate exercise. A healthcare provider can recommend appropriate exercises and/or medications.

Q :   I have a pressure sore on my tailbone. My MS nurse mentioned that this can worsen my spasticity. What are other types of stimuli can aggravate spasticity?
A :   Cutaneous stimuli (those that relate to the skin) that can aggravate spasticity include ingrown toenails, broken or infected skin and tight-fitting clothing. Visceral stimuli (those that relate to internal organs) that can worsen spasticity include bowel dysfunction, bladder infection and urinary retention.